RSNA 19 Puts Spotlight on Radiologists’ Interaction with Patients

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Balancing the patient experience with high case volumes.

The issue – and the opportunity – for radiologists to interact with patients was in the spotlight on day one of RSNA 19.

To highlight the need for radiologists to interact with patients, RSNA President Valerie Jackson, MD, opened her speech with a scenario familiar to many of us.(1) Sitting in frustration on a plane on a tarmac with no communication from the pilot about the projected length of the delay, or the reasons for it.

Then she asked attendees to consider the same circumstance – but imagine that the pilot provides frequent updates on the situation. Then, at the end of the flight, steps outside the cockpit to say farewell to passengers and thank them for their patience.

All people have the need for a human voice, for information, and for reassurance, said Dr. Jackson, emphasizing that interaction with radiologists can help reduce patients’ anxiety and increase their understanding.

Dr. Abraham Verghese of Stanford, CA, illustrated the power of the patient/doctor connection with the iconic painting, “The Doctor,” by Sir Luke Fildes in 1891 (2).

He drew attendees’ attention to the “singular attentiveness of the physician to the patient.” If the portrait was created today, it would show the physician’s attention divided between information on a monitor and the patient.

In his presentation on “Finding the Caring in Care,” (3) Dr. Verghese reminded radiologists to connect the image they are reading to the living and breathing patient it represents. “What patients really want,” he stressed, “is to be recognized, to be witnessed.”

Increased focus on patient and radiologist interaction

The possibility of having increased engagement between radiologists and patients has been discussed for a number of years, said Dr. Jackson, but “it has reached a new level of importance.”

“The importance of improving the patient experience has reached the level of the board of trustees,” echoed Dr. Ramin Khorasani as he introduced a panel on the topic of “Using Imaging Informatics to Enable Patient Experience Improvements in Radiology.”

Why the increased attention? A big driver is that the patient experience and patient satisfaction are now part of Value-based Care. And for many patients, satisfaction requires better access to radiology images, reports, and radiologists themselves, said Andrea K. Borondy Kitts, MPH, MS in her presentation on “Patient Challenges and Wish List for Imaging Informatics.” (3)

Additionally, the ongoing evolution of AI holds promise for offloading some of the non-value-adding processes of radiologists.

“AI tools can help free up radiologists from some of their mundane tasks so they have the time and the energy to interact with patients,” said Janelle Berscheid, a graduate student at the University of Saskatchewan.

Having more direct interaction with patients might benefit radiologists, too, said Dr. Jackson. Experiencing “the deep satisfaction that comes from communicating with patients” could help improve mental health, give more purpose to the radiologist, and reduce errors, she said.

Challenges to changing the radiologist/patient paradigm

While the focus has intensified, many of the roadblocks to patient/radiologist interaction remain. One that was heard repeatedly was the very real pressure to manage high case volume.

Dr. Leonor Eguren of Argentina said she interacts with patients when doing an ultrasound or a biopsy. However, she does not see other patients. “If their exam is not a priority, I might not even read it until 4 hours after it was taken. By then the patient would be gone,” she said. “And the bigger challenge is that radiologists are busy, and we are continually being asked to be more efficient.”

To understand the time impact better, Penn Medicine undertook a study after it provided patients with the option to contact their radiologist by phone following their imaging study. Less than 1 percent of the patients made the call, said Dr. Tessa S. Cook in her presentation ion “Patient-centered Imaging Informatics Innovations. (4)

“When patients did call, their questions usually centered on the report meaning, medical terminology, findings not mentioned, and impact on management,” said Dr. Cook, noting that the average call length was 8 minutes.

Weill Cornell Medicine also provides avenues for patients to contact radiologists. When patients do call, the average length is 3.5 to 4 minutes, said Dr. Keith D. Hentel, MS, New York in his presentation on “Patient Experience: Numbers, Culture, or ?” (5)

Paving the way for interaction between radiologists and patients

The issue – and the opportunity – for patient/radiologist engagement needs to be addressed on several levels, starting at the top.

“Leadership needs to agree that patient engagement is worthwhile even though it is not resource generating. And they need to resource appropriately to give radiologists the time to interact with patients,” emphasized Dr. Khorasani.

As for radiologists, Ms. Borondy had these suggestions to start moving closer to the patient:

• Develop ways for patients to talk to radiologists in the forms of email, text, a patient portal, facetime, Skype or in person.
• Provide patients with helpful resources, like RadiologyInfo.org.
• Develop patient-friendly radiology reports.

In her closing, Dr. Jackson encouraged radiologists to take at least one action to move closer to the patient. Simple tactics she suggested are:

• Introduce yourself
• Ask about their care 
• Ask about the service
• Provide your contact information

I have no doubt that there will still be discussions about the need for increased engagement between patients and radiologists at RSNA 2020. But perhaps there will also be reports on progress made and increased satisfaction for patients and radiologists alike.

Do you have any thoughts or suggestions on the subject? I would love to hear them – please comment below.

#RSNA19 #RSNA2019  #patientengagement

Katie Kilfoyle Remis is the editor of Everything Rad and the global social media manager for Carestream Health.   

Read the related blog: Building Trust Between the Patient and Radiographer in a Digital World

References:

1Jackson,V, Arenson,R, President’s Address: A Matter of Perspective: Putting a New Lens on Our Patient Interactions. Radiological Society of North America 2019 Scientific Assembly and Annual Meeting, December 1 – December 6, 2019, Chicago IL. archive.rsna.org/2019/19004006.html Accessed December 2, 2019

2 https://www.tate.org.uk/art/artworks/fildes-the-doctor-n01522

2 Verghese,A, Jackson,V, Finding the Caring in Care. Radiological Society of North America 2019 Scientific Assembly and Annual Meeting, December 1 – December 6, 2019, Chicago IL. archive.rsna.org/2019/19004007.html Accessed December 1, 2019

3 https://www.tate.org.uk/art/artworks/fildes-the-doctor-n01522

4 Borondy Kitts,A, Patient Challenges and Wish List for Imaging Informatics. Radiological Society of North America 2019 Scientific Assembly and Annual Meeting, December 1 – December 6, 2019, Chicago IL. archive.rsna.org/2019/18024154.html Accessed December 1, 2019

5 Cook,T, Patient-centered Imaging Informatics Innovations. Radiological Society of North America 2019 Scientific Assembly and Annual Meeting, December 1 – December 6, 2019, Chicago IL. archive.rsna.org/2019/18003037.html Accessed December 1, 2019 6 Hentel,K, Patient Experience: Numbers, Culture, or ?. Radiological Society of North America 2019 Scientific Assembly and Annual Meeting, December 1 – December 6, 2019, Chicago IL. archive.rsna.org/2019/18003039.html Accessed December 1, 2019